Endoscopic surgery through the nose in the treatment of skull base tumors
Doctors of Cho Ray Hospital in Ho Chi Minh City have developed and mastered the procedure of endoscopic transnasal surgery in the treatment of craniofacial tumors, helping to improve quality of life and reduce costs for patients.
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There were no surgical complications during transnasal endoscopic surgery. Photo: NNC
Cranial basal tumor is a complex disease, difficult to treat, because the lesion is located deep, adjacent to vital organs, such as the carotid artery, optic nerve, eye, and brain. Surgical intervention, especially extensive surgery, left many sequelae or serious complications, such as facial deformity, spinal fluid, meningitis (accounting for 30-40%).
Surgery for tumors in the base of the skull is very difficult, because in addition to completely resolving the tumor, it is also necessary to preserve vital functions and reconstruct the dark minimal anatomical contours for the patient. Some surgical methods in the treatment of skull base tumors, such as hidden intertemporal surgery, tendon flipping incision to avoid scarring, etc.
Along with the development of endoscopic tools and techniques through the nose, the world has begun to apply endoscopic surgery through the nose to cut skull base tumors, especially anterior cranial basal tumors, in order to improve efficiency of treatment and preservation of facial structures around the tumor.
Currently, in Vietnam, endoscopic nasal surgery is mainly used to treat pituitary tumors. Faced with that fact, a team of doctors from Cho Ray Hospital, Ho Chi Minh City conducted the project "Research on surgery of anterior skull base tumors through nasal endoscopy".
Specifically, the doctors conducted an autopsy to analyze the anterior skull base and operated on 30 patients who were diagnosed with anterior skull base tumors at Cho Ray Hospital. Thereby, doctors develop diagnostic procedures for cranial basal tumors; skull base tumor surgery; reconstruction of craniofacial background; care and monitoring and evaluation after surgery.
For 30 surgical patients, 14 patients had anterior cranial basal tumor resection through transnasal endoscopy, 16 patients had combined surgery (endoscopic and open endoscopic); 25/30 cases were reconstructed skull base using HBF flap (nasal septum flap). For both benign and malignant tumors, there are no complications during surgery. After surgery, there were no cases of benign tumors, but 1 case of malignant tumors (meningitis).
After 5-7 days of surgery, the patients are awake, vital signs are stable, can eat and drink, no cerebrospinal fluid is drained. After 1 month of surgery, the degree of covering the skull membrane was 100%, phenomena such as headache, nasal congestion, nosebleeds, protrusion, vision loss, etc., were significantly reduced compared to before surgery.
The author's project has been accepted by the Ho Chi Minh City Department of Science and Technology. The research team will continue to deploy the technique at Cho Ray Hospital, and at the same time, it can be deployed in hospitals with sufficient physical conditions and facilities to perform surgery.